St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY

Professional

Both

$933.66

Service Code	HCPCS 93303
Min. Negotiated Rate	$700.24
Max. Negotiated Rate	$700.24
Rate for Payer: Cash Price	$254.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$700.24
Rate for Payer: SOMOS Essential	$700.24

PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY

Professional

Both

$693.77

Service Code	HCPCS 93303 TC
Min. Negotiated Rate	$520.33
Max. Negotiated Rate	$520.33
Rate for Payer: Cash Price	$188.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$520.33
Rate for Payer: SOMOS Essential	$520.33

PR COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY

Professional

Both

$239.89

Service Code	HCPCS 93303 26
Min. Negotiated Rate	$179.92
Max. Negotiated Rate	$179.92
Rate for Payer: Cash Price	$65.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$179.92
Rate for Payer: SOMOS Essential	$179.92

PR COMPLEX CHRONIC CARE MGMT SVC 1ST 60 MIN CAL MO

Professional

Both

$367.36

Service Code	HCPCS 99487
Min. Negotiated Rate	$275.52
Max. Negotiated Rate	$275.52
Rate for Payer: Cash Price	$100.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.52
Rate for Payer: SOMOS Essential	$275.52

PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE

Professional

Both

$436.59

Service Code	HCPCS 51727 26
Min. Negotiated Rate	$327.44
Max. Negotiated Rate	$327.44
Rate for Payer: Cash Price	$119.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$327.44
Rate for Payer: SOMOS Essential	$327.44

PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE

Professional

Both

$1,132.46

Service Code	HCPCS 51727 TC
Min. Negotiated Rate	$849.34
Max. Negotiated Rate	$849.34
Rate for Payer: Cash Price	$308.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$849.34
Rate for Payer: SOMOS Essential	$849.34

PR COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE

Professional

Both

$1,569.05

Service Code	HCPCS 51727
Min. Negotiated Rate	$1,176.79
Max. Negotiated Rate	$1,176.79
Rate for Payer: Cash Price	$427.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,176.79
Rate for Payer: SOMOS Essential	$1,176.79

PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES

Professional

Both

$422.63

Service Code	HCPCS 51728 26
Min. Negotiated Rate	$316.97
Max. Negotiated Rate	$316.97
Rate for Payer: Cash Price	$114.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$316.97
Rate for Payer: SOMOS Essential	$316.97

PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES

Professional

Both

$1,560.86

Service Code	HCPCS 51728
Min. Negotiated Rate	$1,170.64
Max. Negotiated Rate	$1,170.64
Rate for Payer: Cash Price	$424.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,170.64
Rate for Payer: SOMOS Essential	$1,170.64

PR COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES

Professional

Both

$1,138.24

Service Code	HCPCS 51728 TC
Min. Negotiated Rate	$853.68
Max. Negotiated Rate	$853.68
Rate for Payer: Cash Price	$309.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$853.68
Rate for Payer: SOMOS Essential	$853.68

PR COMPLEX UROFLOMETRY

Professional

Both

$61.11

Service Code	HCPCS 51741
Min. Negotiated Rate	$45.83
Max. Negotiated Rate	$45.83
Rate for Payer: Cash Price	$16.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45.83
Rate for Payer: SOMOS Essential	$45.83

PR COMPLEX UROFLOMETRY

Professional

Both

$35.39

Service Code	HCPCS 51741 26
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$26.54
Rate for Payer: Cash Price	$9.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26.54
Rate for Payer: SOMOS Essential	$26.54

PR COMPLEX UROFLOMETRY

Professional

Both

$25.73

Service Code	HCPCS 51741 TC
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$19.30
Rate for Payer: Cash Price	$7.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19.30
Rate for Payer: SOMOS Essential	$19.30

PR COMPL OPH XM&EVAL GENERAL ANES W/WO MNPJ GLOBE

Professional

Both

$553.25

Service Code	HCPCS 92018
Min. Negotiated Rate	$414.94
Max. Negotiated Rate	$414.94
Rate for Payer: Cash Price	$152.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$414.94
Rate for Payer: SOMOS Essential	$414.94

PR COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA

Professional

Both

$8,692.25

Service Code	HCPCS 33692
Min. Negotiated Rate	$6,519.19
Max. Negotiated Rate	$6,519.19
Rate for Payer: Cash Price	$2,306.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,519.19
Rate for Payer: SOMOS Essential	$6,519.19

PR COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH

Professional

Both

$8,673.18

Service Code	HCPCS 33694
Min. Negotiated Rate	$6,504.88
Max. Negotiated Rate	$6,504.88
Rate for Payer: Cash Price	$2,303.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,504.88
Rate for Payer: SOMOS Essential	$6,504.88

PR COMPL RPR T-FALLOT W/PULM ATRESIA

Professional

Both

$9,136.96

Service Code	HCPCS 33697
Min. Negotiated Rate	$6,852.72
Max. Negotiated Rate	$6,852.72
Rate for Payer: Cash Price	$2,426.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,852.72
Rate for Payer: SOMOS Essential	$6,852.72

PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL

Professional

Both

$517.76

Service Code	HCPCS 51729 26
Min. Negotiated Rate	$388.32
Max. Negotiated Rate	$388.32
Rate for Payer: Cash Price	$140.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$388.32
Rate for Payer: SOMOS Essential	$388.32

PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL

Professional

Both

$1,654.56

Service Code	HCPCS 51729
Min. Negotiated Rate	$1,240.92
Max. Negotiated Rate	$1,240.92
Rate for Payer: Cash Price	$447.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,240.92
Rate for Payer: SOMOS Essential	$1,240.92

PR COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL

Professional

Both

$1,136.77

Service Code	HCPCS 51729 TC
Min. Negotiated Rate	$852.58
Max. Negotiated Rate	$852.58
Rate for Payer: Cash Price	$307.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$852.58
Rate for Payer: SOMOS Essential	$852.58

PR COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION

Professional

Both

$20,401.40

Service Code	HCPCS 61697
Min. Negotiated Rate	$15,301.05
Max. Negotiated Rate	$15,301.05
Rate for Payer: Cash Price	$5,354.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,301.05
Rate for Payer: SOMOS Essential	$15,301.05

PR COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ

Professional

Both

$126.63

Service Code	HCPCS 92557
Min. Negotiated Rate	$94.97
Max. Negotiated Rate	$94.97
Rate for Payer: Cash Price	$34.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$94.97
Rate for Payer: SOMOS Essential	$94.97

PR COMPRE AUDIOM THRESHOLD EVAL & SPEECH RECOG

Professional

Both

$163.07

Service Code	HCPCS 0212T
Min. Negotiated Rate	$122.30
Max. Negotiated Rate	$122.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$122.30
Rate for Payer: SOMOS Essential	$122.30

PR COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS

Professional

Both

$328.13

Service Code	HCPCS 96000
Min. Negotiated Rate	$246.10
Max. Negotiated Rate	$246.10
Rate for Payer: Cash Price	$90.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$246.10
Rate for Payer: SOMOS Essential	$246.10

PR COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG

Professional

Both

$450.91

Service Code	HCPCS 96001
Min. Negotiated Rate	$338.18
Max. Negotiated Rate	$338.18
Rate for Payer: Cash Price	$122.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$338.18
Rate for Payer: SOMOS Essential	$338.18

Know your out-of-pocket cost for care.

All Charges